Transitioning to Adulthood with Autism: Ethical, Legal and Social Issues (The International Library of Bioethics, 91)

Contents
Contributors
1 Introduction
	References
2 Legal and Financial Issues Related to Transition
	2.1 Introduction
		2.1.1 Legal Issues
	2.2 Medical Decision-Making
		2.2.1 Health Care Power of Attorney
	2.3 Decision-Making Capacity
	2.4 Sexual Decision-Making and Consent
	2.5 Financial Issues
		2.5.1 Shifting from Entitlement to Eligibility
	2.6 Supplemental Security Income (SSI)
	2.7 Student Earned Income Exclusion (SEIE)
	2.8 Plan to Achieve Self-support (PASS)
	2.9 Social Security Disability Insurance (SSDI)
	2.10 Medicaid
	2.11 Home and Community Based Services (HCBS) Medicaid Waiver
	2.12 Private Health Insurance
	2.13 Employment and Earnings
	2.14 Unemployment/Underemployment
	2.15 Money Management
	2.16 Financial Impacts on Parents and Families
	2.17 Healthcare Costs for ASD Adults
	2.18 Non-medical Supports and Services
	2.19 Need for Costly Interventions into Adulthood
	2.20 Housing
	2.21 Impact on Parental Earnings and Ability to Work
	2.22 Financial Planning for Transition
	2.23 ABLE Accounts
	2.24 Special Needs Trusts
	2.25 Conclusion
	References
3 Health Care and Transition
	3.1 Introduction
	3.2 The Transition Timeline
	3.3 Transition Readiness Assessment
	3.4 The Portable Medical Summary
	3.5 Autism Management Plan
	3.6 Handoff
	3.7 Resources and Putting It All Together
	References
4 The Taboo Should Be Taught: Supporting Autistic Young Adults in Their Sexuality, Intimacy, and Relationships
	4.1 Introduction
	4.2 Sexuality, Autism, and Transition
	4.3 Theoretical Framework
	4.4 Chapter Organization
	4.5 Sexuality and Intimacy
		4.5.1 Overview
		4.5.2 Risks and Barriers
		4.5.3 Supports
	4.6 Relationships
		4.6.1 Overview
		4.6.2 Risks and Barriers
		4.6.3 Supports
	4.7 Gender and Sexual Identity
		4.7.1 Overview
		4.7.2 Risks and Barriers
		4.7.3 Supports
	4.8 Sexuality Education
		4.8.1 Overview
		4.8.2 Risks and Barriers
		4.8.3 Supports
	4.9 Implications for Transition to Adulthood
	4.10 Conclusion
	Appendix
	References
5 Transition and Education
	5.1 Introduction
	5.2 What is Transition Planning?
	5.3 Timing of Transition Planning
	5.4 Linking Educational Goals to the Transition Plan
	5.5 Using Assessments to Develop Strong Goals
	5.6 Exploring and Creating Options
	5.7 Determining ‘Success’
	5.8 Where Do We Go from Here?
	5.9 Appendix 1: Page 2 of the Giant Steps PREP Packet
	References
6 Employment Issues Related to Transition: Lessons from Aspiritech
	6.1 Introduction
	6.2 Background
	6.3 Beginning
	6.4 Onboarding and Interviewing
	6.5 Quality Assurance and Software Testing
	6.6 Training
	6.7 Work Routine
	6.8 Support
	6.9 Sensory Issues
	6.10 Distractions
	6.11 Changes
	6.12 Understanding Job Directions by Using Written Instructions
	6.13 Communication
	6.14 Lunch Discussions
	6.15 Social Opportunities and After-Work Activities
	6.16 Sexual Orientation
	6.17 Summary
	References
7 Driving/Transportation and Transition
	7.1 Importance of Transportation for Adulthood
	7.2 Independent Driving
		7.2.1 Who Are Autistic Drivers?
		7.2.2 The Decision to Drive
		7.2.3 Challenges and Barriers to Driving
		7.2.4 The Learning-to-Drive Process
		7.2.5 Police Interactions
		7.2.6 Recommendations for Families and Clinicians
	7.3 Other Forms of Transportation
		7.3.1 Addressing Challenges of Other Transportation
	References
8 Autism and Voting Rights
	8.1 Historical Perspective: Disability Rights and Voting Rights
	8.2 Autistic Adults and the Right to Vote
	8.3 Guardianship and Autism
	8.4 Alternative Solutions to Ensuring the Right to Vote for Autistic Adults
	8.5 “Proxy” Voting for Severely Autistic Adults
	8.6 Limited Guardianship
	8.7 Supported Decision Making
	8.8 Conclusion
	References
9 Autism, the Criminal Justice System, and Transition to Adulthood
	9.1 Introduction
	9.2 Examples
	9.3 Values and Dilemmas
	9.4 Understanding and Complying
	9.5 Navigating Encounters
	9.6 Assessing Guilt
	9.7 Shared Responsibility, Structuring Causes
	9.8 Determining an Appropriate Response or Punishment for Those Who Are Guilty
	9.9 Conclusion
	References
10 Social Media/Online Behavior and Transition: A Personal Story of an Attorney Father About His Autistic Son and the Criminal Justice System
	10.1 Introduction
	10.2 History of Nick's Development
	10.3 Nick's College Years
	10.4 Nick, Sexuality & the Criminal Charges
	References
11 A Personal Perspective on Autism and Transition
Index